Provider Demographics
NPI:1770926644
Name:KEARNS, RICHARD (RN)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:KEARNS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SE SENTRY DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:99324-4002
Mailing Address - Country:US
Mailing Address - Phone:509-200-0691
Mailing Address - Fax:
Practice Address - Street 1:800 SE SENTRY DR
Practice Address - Street 2:
Practice Address - City:COLLEGE PLACE
Practice Address - State:WA
Practice Address - Zip Code:99324
Practice Address - Country:US
Practice Address - Phone:509-200-0691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60181322163W00000X
CA95163833163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse